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chronic surgical pain

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https://www.readbyqxmd.com/read/30118896/opioid-prescribing-guidelines-for-common-surgical-procedures-an-expert-panel-consensus
#1
Heidi N Overton, Marie N Hanna, William E Bruhn, Susan Hutfless, Mark C Bicket, Martin A Makary
BACKGROUND: One in 16 surgical patients prescribed opioids become long-term users. Overprescribing opioids after surgery is common and the lack of multidisciplinary procedure-specific guidelines contributes to the wide variation in opioid prescribing practices. We hypothesize a single-institution, multidisciplinary expert panel can establish consensus on ideal opioid prescribing for select common surgical procedures. STUDY DESIGN: We used a 3-step modified Delphi method involving a multidisciplinary expert panel of 6 relevant stakeholder groups (surgeons, pain specialists, outpatient surgical nurse practitioners, surgical residents, patients, and pharmacists) to develop consensus ranges for outpatient opioid prescribing at the time of discharge after 20 common procedures in 8 surgical specialties...
August 2, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/30118503/adhesion-awareness-in-2016-an-update-of-the-national-survey-of-surgeons
#2
Sebastiaan van Steensel, Leontine C L van den Hil, Marc H F Schreinemacher, Richard P G Ten Broek, Harry van Goor, Nicole D Bouvy
BACKGROUND AND AIMS: Adhesions, that form in 60-80% of all abdominal operations, can cause complications such as chronic abdominal pain, small-bowel obstruction, female infertility, and the need for adhesiolysis in future surgeries. Our 2010 Adhesion Awareness survey demonstrated that despite the huge clinical impact of adhesions; adhesion-related complications were seldom mentioned in the informed consent. Six years later, a follow-up survey was conducted to assess the progress on awareness on adhesion-related complications in the Netherlands...
2018: PloS One
https://www.readbyqxmd.com/read/30112937/a-rare-complication-of-ileostomy-obstruction-boerhaave-syndrome
#3
D Yap, M Ng, N Mbakada
Small bowel obstruction is the most common surgical emergency after a patient has had abdominal surgery. However, Boerhaave syndrome secondary to an ileostomy obstruction has not been reported in current literature. We present a rare case of two concurrent surgical emergencies in a patient with Boerhaave syndrome and small bowel obstruction. A 38-year-old woman presented with sudden onset severe central chest pain associated with breathlessness. She had a history of Crohn's disease, which had been treated with pancolectomy and ileostomy...
August 16, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/30112716/comparing-endoscopic-and-open-decompression-of-the-ulnar-nerve-in-cubital-tunnel-syndrome-a-prospective-randomized-study
#4
T Krejčí, Z Večeřa, O Krejčí, D Šalounová, M Houdek, Radim Lipina
BACKGROUND: Prospective randomized data is currently lacking which compares endoscopically assisted surgery with open surgical techniques in the treatment of cubital tunnel syndrome (CUTS). The aim of this study is to compare patient outcome in both techniques. METHOD: This prospective study comprised of 45 patients who, between October 2014 and February 2017, were randomly assigned to undergo either endoscopic or open surgery (22 and 23 patients respectively) for decompression of the ulnar nerve...
August 15, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/30109502/a-contemporary-perspective-on-the-management-of-post-craniotomy-headache-and-pain
#5
REVIEW
Bryan Lutman, Jamie Bloom, Brandon Nussenblatt, Victor Romo
PURPOSE OF REVIEW: This article discusses the etiology and management of post-craniotomy headache and pain. A review of available as well as investigatory treatment modalities is offered, followed by suggestions for optimal management of post-craniotomy headache. RECENT FINDINGS: There is a dearth of evidence-based practice regarding the differential diagnosis, natural history, and management of post-craniotomy headache. The etiology of post-craniotomy headache is typically multifactorial, with patients' medical history, type of craniotomy, and perioperative management all playing a role...
August 14, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/30109436/what-role-does-metal-allergy-sensitization-play-in-total-knee-arthroplasty-revision
#6
David R Lionberger, Justin Samorajski, Charlie D Wilson, Andreana Rivera
BACKGROUND: Clinicians are often faced with the decision whether to revise a painful total knee replacement in patients who have chronic vague pain with no apparent explanation. A sensitive metal testing assay called the lymphocyte stimulation test has been used to detect nickel sensitization in patients with orthopedic implants. We hypothesize that nickel sensitization plays a role in the pathology of failed joint arthroplasty in patients with unexplained dissatisfaction. METHODS: 32 patients with symptomatic total knee arthroplasty without obvious mechanical findings were tested prior to revision surgery...
August 14, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/30109139/symptomatic-spinal-epidural-lipomatosis-after-combined-hormonal-and-steroidal-palliative-therapy-of-prostate-cancer
#7
Amir Awwad, Renan E Ibrahem Adam, Chandni Patel, James D Thomas
Introduction: Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing's syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Surgical decompression is known to improve symptomatic cases and prevent further deterioration. Case presentation: An elderly male patient with background history of high-risk metastatic prostate cancer and long-term treatment with steroids and hormonal therapy presented with acute on chronic back pain and neurological symptoms...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/30107242/risk-of-pain-and-gastrointestinal-complaints-at-six-months-after-elective-abdominal-surgery
#8
Chema Strik, Barend van den Beukel, Dagmar van Rijckevorsel, Martijn W J Stommel, Richard P G Ten Broek, Harry van Goor
The incidence of chronic postoperative abdominal pain (CPAP) after abdominal surgery is substantial and decreases overall quality of life. One in three patients report to have pain-related interference with mood, sleep and enjoyment of life and 12% visit the emergency department for pain related symptoms. Previous studies lack data on preoperative health and pain status, or are limited by small patient samples. The aim of this study is to assess risk factors for CPAP and gastrointestinal complaints six months after surgery...
August 11, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/30098784/risk-of-plate-removal-in-free-flap-reconstruction-of-the-mandible
#9
C Burton Wood, Justin R Shinn, Shaunak N Amin, Sarah L Rohde, Robert J Sinard
OBJECTIVES: To evaluate the factors associated with need for removal of fixation plates in mandibular free flap reconstruction. METHODS: This retrospective cohort analysis reviews patients undergoing mandibular free flap reconstruction at a tertiary care center from 2005 to 2016. Patients requiring removal of fixation plates were identified through electronic medical records. Factors including demographics, adjuvant therapy, surgical site infection (SSI) and fistula rates were compared...
August 2018: Oral Oncology
https://www.readbyqxmd.com/read/30092436/long-term-outcomes-of-percutaneous-stenting-of-aortic-endograft-limb-occlusion
#10
Stavros Spiliopoulos, Konstantinos Moulakakis, Konstantinos Palialexis, Chrysostomos Konstantos, Lazaros Reppas, Ioannis Kakisis, Andreas Lazaris, George Geroulakos, Elias Brountzos
PURPOSE: To investigate the safety and efficacy of percutaneous stenting for the management of chronic ischemia caused by endograft limb occlusion following endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: This is a retrospective, single-centre study investigating all patients who underwent percutaneous endovascular covered or bare metal stent placement for the management of intermittent claudication (IC) or critical limb ischemia (CLI) following EVAR limb occlusion, between January 2010 and October 2017...
August 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30084824/risk-of-opioid-related-adverse-events-after-primary-and-revision-total-knee-arthroplasty
#11
Jeff Gonzales, Scott T Lovald, Edmund C Lau, Kevin L Ong
Postoperative analgesia after primary total knee arthroplasty (TKA) and revision knee arthroplasty (RKA) can be reliant on the use of opioids and may lead to opioid-related adverse events (ORAEs). This study evaluated the risk of ORAEs following TKA and RKA using the 5% Medicare claims (2010-2013) database. There were 41,702 TKA and 3817 RKA patients who met the inclusion criteria. At 90 days, respiratory complications were the most common complication (TKA: 6.12%; RKA: 8.01%), followed by postoperative nausea and vomiting (TKA: 2...
December 0: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/30079938/anatomic-revascularization-of-the-celiac-trunk-and-the-superior-mesenteric-artery
#12
Murat Ugurlucan, Nihat Aksakal, Yilmaz Onal, Didem Melis Oztas, Ufuk Alpagut
Chronic atherosclerotic mesenteric ischemia is a debilitating disorder. It may cause postprandial abdominal pain leading to severe weight loss. Patients are usually emotionally affected with major depression. The disease can be treated with open surgical and endovascular techniques and both methods have individual risks and benefits. In this report, the authors present anatomical revascularization of the superior mesenteric artery and the celiac trunk.
February 2018: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/30079285/extreme-lateral-interbody-fusion-complicated-by-fungal-osteomyelitis-case-report-and-quick-review-of-the-literature
#13
Ronen Blecher, Emre Yilmaz, Marc Moisi, Rod J Oskouian, Jens Chapman
The authors describe a 67-year-old man with a prior history of alcohol abuse who presented with a complaint of worsening low back pain. Four months prior to his presentation, the patient had undergone extreme lateral interbody fusion (XLIF) of his lumbar 3-4 segment for the treatment of his chronic low back and legs pain. Imaging revealed a loosening of his interbody fusion implant on top of his prior lumbar spine instrumentation. In surgery, the removal of his loose implant was followed by decompression, the stabilization of the collapsed segment, and the implant of antibiotic-impregnated polymethyl-methacrylate (PMMA) spacer and beads...
May 31, 2018: Curēus
https://www.readbyqxmd.com/read/30073475/association-of-g472a-allele-of-membrane-bound-catechol-o-methyltransferase-gene-with-chronic-post-sternotomy-pain
#14
Goduguchintha Dharaniprasad, Aloka Samantaray, Mangu Hanumantha Rao, Abha Chandra, Potukuchi Venkata Gurunadha Krishna Sarma
Chronic persistent surgical pain (CPSP) is a complex disease with strong genetic component. The studies on revealed association of mutations in membrane bound catechol-O-methyltransferase gene with CPSP were reported indifferent ethnic populations across the globe. We identify that one out of four patients who underwent sternotomy procedure showed CPSP even after 3 months of surgery. The Mb.COMT gene sequence analysis revealed of the four patients, three patients had no mutation in Mb.COMT gene, while in one patient exhibited G472A mutation...
August 2, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30073104/treatment-of-a-neglected-patellar-tendon-rupture-with-a-modified-surgical-technique-ipsilateral-semitendinosus-autograft-reconstruction-with-suture-tape-augmentation
#15
Sanjum P Samagh, Fernando A Huyke, Lucas Buchler, Michael A Terry, Vehniah K Tjong
Patellar tendon ruptures are rare, but debilitating injuries are typically seen in young active males in the third and fourth decades of life. They can occur as a single acute injury or from repetitive microtrauma weakening the tendon. Patients typically present complaining of knee pain, swelling, and an inability to perform a straight leg raise. Most conventionally, these injuries are classified as acute (less than two weeks) or chronic (greater than two weeks) based upon the timing of presentation. In patients with patellar tendon ruptures and inability to perform a straight leg raise, patellar tendon repair is most often recommended...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/30065342/single-institution-analysis-of-incidence-and-risk-factors-for-post-mastectomy-pain-syndrome
#16
Lingfei Cui, Ping Fan, Chaoxue Qiu, Yong Hong
Post Mastectomy Pain Syndrome (PMPS) is a common postoperative condition for breast cancer, but has been ignored. The aim of this study was to investigate the prevalence of PMPS and the risk factors in women submitted to surgical treatment for breast cancer. The study included 532 postoperative breast cancer patients in a hospital for five consecutive years period, of whom 473 were considered eligible and included in the study. A total of 420 people completed a questionnaire survey, which revealed that 152 (36...
July 31, 2018: Scientific Reports
https://www.readbyqxmd.com/read/30064840/the-impact-of-psychiatric-comorbidities-on-patient-reported-surgical-outcomes-in-adults-treated-for-the-median-arcuate-ligament-syndrome
#17
Christopher L Skelly, Colleen Stiles-Shields, Grace Z Mak, Christopher R Speaker, Jonathan Lorenz, Magdalena Anitescu, David M Dickerson, Hope Boyd, Setareh O'Brien, Tina Drossos
OBJECTIVE: Median arcuate ligament syndrome (MALS) is an often overlooked, surgically correctable condition that mimics functional chronic abdominal pain. Patient-reported surgical outcomes are unpredictable in MALS. The objective of this study was to define the psychiatric comorbidities in a cohort of adults undergoing surgery for MALS and to determine whether these comorbidities are predictive of patient-reported quality of life (QOL) outcomes. METHODS: A prospective observational trial was conducted between April 1, 2010, and December 31, 2015, at a single tertiary care hospital...
July 28, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/30064607/hardness-and-painful-lesion-of-the-breast
#18
Alejandro Vilas-Sueiro, Daniel González-Vilas, Cristina Aguilera, Benigno Monteagudo, Cristina De De Las Heras
Dear Editor, Lupus panniculitis or lupus profundus is a rare inflammatory complication found in patients with systemic lupus erythematosus (SLE), or discoid lupus erythematosus (DLE) (1). When the breast is involved, the term lupus mastitis (LM) is used. This disease involving the breast is rare, and the lesions may precede, coincide with, or occur later than the onset of other lupus lesions. Tissue biopsy is required to confirm the suspected diagnoses of LM. We report a case of a patient with lupus mastitis due to the important differential diagnosis...
December 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/30064602/subcutaneous-granuloma-annulare
#19
Tatiana Ţăranu, Mirela Grigorovici, Magda Constantin, Mihaela Paula Toader
Dear Editor, Subcutaneous granuloma annulare (SGA) is considered a rare clinical variant of granuloma annulare, a common self-healing chronic inflammatory disorder that may appear in childhood as well as in adult age (1-3). A 29-year-old female patient reported the onset of several small subcutaneous nodules on the dorsal aspect of the second interphalangeal joint of the left medius finger and the left elbow, accompanied by vague joint pain, had occurred 13 years ago. Specific markers for rheumatoid arthritis were negative, leading to a diagnosis of sero-negative rheumatoid arthritis, for which treatment with methotrexate was initiated...
December 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/30059445/multidirectional-instability-of-the-shoulder-treatment-options-and-considerations
#20
Matthew J Best, Miho J Tanaka
Multidirectional instability (MDI) is a debilitating condition that involves chronic subluxation or dislocation of the shoulder in >1 direction. Numerous proposed mechanisms of MDI exist, which occurs in the setting of redundant capsular tissue. Symptoms can range from recurrent dislocations or subluxations to vague aching pain that disrupts activities of daily living. Magnetic resonance imaging is often performed during evaluation of this condition, although magnetic resonance arthrography may provide more detailed images of the patulous capsule...
September 2018: Sports Medicine and Arthroscopy Review
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